CMS Delays Enforcement of Version 5010 for Additional 3 Months

The Centers for Medicare and Medicaid Services' (CMS) Office of E-Health Standards and Services (OESS) has delayed the enforcement of HIPAA Version 5010 through June 30 for covered entities that are required to comply with the updated transactions standards.

The new standards went into effect January 1. However, in November 2011, OESS announced it would delay enforcement until the end of March to allow covered entities to complete outstanding implementation activities, including software installation, testing, and training. Although covered entities have been making steady progress, OESS has extended its enforcement discretion period for an additional 3 months.

During this additional delay, OESS is stepping up its existing outreach to include more technical assistance for covered entities. It also is partnering with industry groups and the Medicare fee-for-service (FFS) program and Medicaid to expand technical assistance opportunities and eliminate remaining barriers.

The Medicare FFS program will continue to host separate provider calls to address outstanding issues related to Medicare programs and systems. Medicare Administrative Contractors will continue to work closely with clearinghouses, billing vendors, or health care providers requiring assistance in submitting and receiving Version 5010 compliant transactions.

Last month, APTA launched a new Web page that contains resources to help physical therapists transition to HIPAA Version 5010. In addition to implementation information, the association has designed an online complaint form for members who are having issues transitioning to the new standards. After the form is completed and submitted online, APTA will forward the issue to CMS.